International Health Regulation update and progress in the region

Transcription

1 International Health Regulation update and progress in the region 7 th Meeting of CAPSCA Asia Pacific May 2014 Colombo, Sri Lanka Dr Bardan Jung Rana International Health Regulation WHO South-East Asia Regional Office

2 What are International Health Regulations (2005)? An internationally agreed instrument for global public health security Represents the joint commitment for shared responsibilities and collective defence against disease spread Legally binding for WHO Member States since June 2007

3 What is the purpose of the IHR (2005)? To prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade Article 2

4 What do the IHR call for? Strengthened national capacity for surveillance and control, designated points of entry (PoE) in travel and transport IHR (2005) A commitment of 195 States Parties Prevention, alert and response to international public health emergencies Global partnership and international collaboration Rights, obligations and procedures, and progress monitoring

5 National Core Capacity Requirements IHR National Core Capacities should be strengthened across the five relevant hazards and the points of Entry Annex 1 8 Core Capacities Legislation and Policy Coordination Surveillance Response Preparedness Risk Communications Human Resources Laboratory Potential hazards Infectious Zoonosis Food safety Chemical Radio nuclear Points of Entry IHR 2005

6 IHR Requirements for Core capacities States Parties shall utilize existing national structures and resources to meet their core capacity requirements under these Regulations, including with regard to: their surveillance, reporting, notification, verification, response and collaboration activities; their activities concerning designated airports, ports and ground crossings. Including inspections of conveyances

7 In 2012, 38 States Parties have not requested an extension to the initial target date of June 2012 (AMRO: 4, EMRO: 1, EURO: 20, WPRO: 13) The rest requested extension until June 2014 including all 11 countries of SEARO. As of 6 May2014, 55 States Parties globally have requested a second extension (AFRO: 5, AMRO: 19, EMRO: 11, EURO: 4, SEARO: 8, WPRO: 8), 17 countries did not request a further extension because the national IHR core capacities requirements have been achieved (AMRO: 6, EMRO: 6, EURO: 1, SEARO: 2, WPRO: 2). Based on informal communications, a second extension is expected for four countries (AMRO: 1, EMRO: 2, SEARO: 1), while five States Parties indicated that a further extension will not be sought (AMRO: 2, EMRO: 1, WPRO: 2).

8 Global Average attribute scores for IHR core capacities, PoE and IHR-relevant hazards, % 74% 81% 79% 73% 76% 81% 72% 65% 61% 57% 56% 54%

9 SEAR Average attribute scores for IHR core capacities, PoE and IHR-relevant hazards, 2012 and % 78% 84% 70% 77% 78% 77% 77% 77% 69% 74% 79% 66% 69% 76% 77% 65% 83% 75% 81% 59% 60% 50% 44% 37% 29%

10 WPR Average scores for IHR core capacities, PoE and IHRrelevant hazards, 2012 and % 1. Legislation 80% 76% 2. Coordination 83% 83% 3. Surveillance 85% 85% 4. Response 88% 70% 5. Preparedness 78% 74% 6. Risk Communication 88% 58% 7. Human Resources 72% 72% 8. Laboratory 80% 62% 9. Points of Entry 68% 71% 10. Zoonotic 80% 70% 11. Food Safety 79% 48% 12. Chemical 57% 45% 13. Radiological 49%

11 Regional Activities Supporting Core Capacity

12 Regional Activities Supporting Core Capacity -SEAR A regional workshop on Public Health legislation in Yangon, Myanmar The bi-regional APSED (Asia Pacific Strategy for Emerging Disease ) 2013 in Kathmandu, Nepal Assessment of integrated disease surveillance (EBS & EWAR) 2013 undertaken in IND, INO,MAL & THA Plan for Regional Training Workshop on Risk Assessment and Risk Management this year SEARO is developing the Health Emergency Risk Management Framework A bi-regional meeting on influenza in Beijing, China A bi-regional training on clinical management of influenza and SARS 2014 Nanjing, China The next NIC meeting planed in August 2014, Bali, Indonesia Training on international outbreak response (under GOARN) 2012, Medan Indonesia. Further training is planned

13 Regional Activities Supporting Core Capacity - SEAR Communication in Behavioural Impact (ComBI) and Media training Continue to strengthen media capacity for outbreak prone/emerging infectious diseases in the region and identify appropriate communications technologies for risk communications Regional training in media risk communication planned Enhancing capacity for Field Epidemiology Training (FET) DPRK Regional workshop and training on lab diagnosis, quality management and bio safety / bio security Regional meeting on strengthening capacities at Points of Entry in Kochi, Training on Ship Sanitation and certification 2013, Kochi, India Assistance visit to review Nepal International Airport 2012 and Sri Lanka International Airport 2013 Support to national assessments as requested Regional IHR / APSED meeting planned - June 2014, Bangkok, Thailand A guideline on healthcare facility preparedness for infectious disease outbreaks is being finalized which will be followed by development of training materials Updating IPC training materials to cover H7N9 is planned for this biennium

14 Regional Activities Supporting Core Capacity - SEAR Regional meeting on zoonotic diseases 2013 in Chiang Mai, Thailand Tripartite FAO / OIE/ WHO Regional Workshop on Multi-Sectoral Collaboration on Zoonoses Prevention and Control in Kathmandu, Nepal Advocating Regional Strategy Framework for elimination of human Rabies in SEA Regional meeting on Nutrition and Food Safety in Jakarta, Indonesia Bi-Regional INFOSAN meeting in Manila A Regional Strategy for Food Safety is being developed following a consultation in late 2013 An informal consultation on strengthening regional capacity for preparedness, detection and response to chemical and radio-nuclear events in the context of IHR 2013, Bangkok, Thailand Regional meeting on Public Health Response to chemical and radio-nuclear events in the context of IHR 2013, Colombo, Sri Lanka Regional Strategy for South East Asia to strengthen Public Health Response to Chemical and Radiological Safety in the context of IHR being finalized.

15 Regional Key Activities Supporting IHR Core Capacity Development - WPR Regional Meetings: Annual meetings of the Technical Advisory Group on the Asia Pacific Strategy for Emerging Diseases Annual meetings of National Influenza Centers Laboratory Strengthening for EID, June 2013, Manila IHR, APSED and the Pacific Public Health Surveillance Network, May 2012, Fiji Informal Consultations Public Health Emergency Planning, March 2012, Manila Emergency Operations Centre and Response Logistics, May 2012, Manila Risk Communications, June 2012, Kuala Lumpur Risk Assessment Tools, August 2012 Monitoring and Evaluation for APSED, January 2014, Manila Strengthening Surveillance Systems for Food Safety-related Illnesses, February 2014, Manila Enhance the External Quality Assessment Programme for EIDs, April 2014, Singapore 15

16 Regional Activities Supporting IHR Core Capacity Development - WPR Workshops and Trainings Annual workshops on Zoonosis Annual workshops on Field Epidemiology Training Programme IATA Training, July 2012, Lao PDR Asia-Pacific Dengue workshop, Sept 2012, Singapore Field Epidemiology Fellows in Risk Assessment, October 2012, Tokyo Leptospirosis Laboratory Training for ASEAN Member States, October 2012, Philippines Points of Entry, April 2013, Ningbo, China Sequencing and Phylogenetic Analysis, April 2013 IATA Training, September 2013, Malaysia Training for Clinical Management of Avian Influenza A (H7N9) in humans and Severe Acute Respiratory Infection (SARI), May 2014, China 16

17 Existing Regional / Bi-regional Strategic Frameworks Asia Pacific Strategy for Emerging Diseases Asia Pacific Strategy for Strengthening of Health Laboratories SEA Region Benchmarks for Emergency Preparedness and Response Regional Strategy for Food Safety Regional Strategy for Chemical and Radiological Safety in the context of IHR

18 Core Capacities: Points of Entry At all times (routine) Access to medical service Transport of ill travellers Inspection of conveyances (e.g. Ship Sanitation Control Certificate) Control of vectors / reservoirs For responding to public health related events Emergency contingency plan Arrangement for isolation (human, animal) Space for interview / quarantine Apply specific control measures

19 EXPECTED RESULTS with IHR implementation at PoE Facilities at points of entry are maintained in a sanitary condition, kept free of infection or contamination, including vectors and reservoirs. Routine measures are in place for travellers, conveyances, cargo, goods and postal parcels. A contingency plan for public health emergencies is effectively available and operational at all designated PoE and in all countries. Capacity to rapidly implement international public health recommendations at designated points of entry. Coordination between WHO and other Organizations

20 Challenges Implementing IHR at points of entry Designating PoE and identifying competent authorities for implementing IHR at PoE. Listing authorized ports able to implement ship sanitation certificates - SSC Strengthening links of PoE with national health surveillance and response system. Updating national legislation and harmonization of IHR requirements with enforcement of provisions from others International agreements (e.g. ICAO, IMO, ILO Conventions) Strengthening intersectoral collaboration and coordination for designation, assessment and development of routine and response core capacity at PoE (e.g. transport, customs, immigration, environment, etc.) To have harmonized best practices at PoE in a globalized world and in a all hazards approach.

21 WHO Support for Strengthening Public Health Capacity at Points of Entry - POE MISSION ACTIVITIES Provide technical support and advice for preventing, detecting, controlling Public Health risks Foster international collaboration in a multisectoral approach Guidelines Trainings Activities in WHO Regions Networking

22 implementation of International Health Regulation (2005) at Points of Entry in South East Asia Region Results from 2013 self-reported data

23 Progress in implementation of IHR (2005) at PoE in SEAR: Results from 2013 self-reported data Total number of airports that have been designated Number of designated airports where Competent Authority been identified There are 28 designated airports in all Member States in SEAR At 27/28 (96%) of the airports CA has been identified in 10 MS Number of airports where assessment has been done 19/ 28 (68%) airports which have been designated have been assessed

24 Progress in implementation of IHR (2005) at PoE in SEAR: (2) Results Progress from in preparedness 2013 self-reported and Response. data Number of airports having access to appropriate medical services including diagnostic facilities for the prompt assessment and care of ill travelers and with adequate staff, equipment and premises Mechanisms for the exchange of information SOPs for response at designated Air Ports 25 / 28 airports (89%) in 10/11 MS (91%) have this provision Mechanisms for the exchange of information between designated PoE and medical facilities exist in 10/11 (91%) MS SOPs for Response are available in 64% of designated airports

25 Progress in implementation of IHR (2005) at PoE in SEAR: Results from 2013 self-reported data (3) Progress in preparedness and response Number of designated airports that can provide quarantine for suspect travelers, and care for affected travelers or animals 24/ 28 of the airports ( 86%) can provide medical assessment and quarantine for suspect travelers, the facilities for this are available in all MS Number of designated airports that have appropriate space, separate from other travelers, to interview suspect or affected persons Number of designated Airports that has an established and maintained public health emergency contingency plan to provide public health emergency response 24/ 28 airports have the appropriate space to carry out this function ( 86%) 25/ 28 (89%) airports have made this provision but this PHECP is available in (8/11) MS ( 73%) including a coordinator and contact points for relevant points of entry

26 (1) Progress in implementation of IHR (2005) at PoE in WPR: Results from 2013 self-reported data Total number of airports that have been designated There are 130 designated airports in all IHR States Parties in WPR Number of designated airports where Competent Authority has been identified At 103/130 (79%) of the airports CA has been identified. Number of airports where assessment has been done 86/130 (66%) airports which have been designated have been assessed 26

27 (2) Progress in implementation of IHR (2005) at PoE in WPR: Results from 2013 self-reported data Number of airports having access to appropriate medical services including diagnostic facilities for the prompt assessment and care of ill travelers and with adequate staff, equipment and premises Mechanisms for the exchange of information SOPs for response at designated airports 97/130 airports (75%) have this provision Mechanisms for the exchange of information between designated PoE and medical facilities exist in 23/26 States Parties SOPs for response are available in 18/26 States Parties 27

28 (3) Progress in implementation of IHR (2005) at PoE in WPR: Results from 2013 self-reported data Number of designated airports that can provide quarantine for suspect travelers, and care for affected travelers or animals Number of designated airports that have appropriate space, separate from other travelers, to interview suspect or affected persons Number of designated airports that have an established and maintained public health emergency contingency plan to provide public health emergency response 95/130 of the airports (73%) can provide medical assessment and quarantine for suspect travelers 88/130 airports have the appropriate space to carry out this function (68%) 85/130 (65%) airports have made this provision. 28

29 Developing capacities at points of entry WHO Activities WHO to continue supporting State Parties for designating ports, airports and ground crossings for development of plans and to implement IHR core capacities at PoE Fostering International collaboration and harmonization of practices (WHO Collaborating Centers, CAPSCA, SHIPSAN, AIRSAN, etc..) Development and update of more specific technical guidance documents Development and update of learning tools WHO PAG database-search tool Development of WHO Guidance and procedures for certification of airports and ports

30 WHO PoE Guidance and tools - PUBLISHED Air travel Public health emergency preparedness Ports and Ships PoE core capacity checklist WHO Learning Program for Ship Inspection and Issuance of SSC under IHR 2005

31 WHO PoE Guidance and tools under development Event management WHO Technical Advice for Event Management in Air Transport WHO Technical Advice for Event Management on board ships Strengthening Coordinated Surveillance at points of entry Others Procedures for Airport and Port Certification Ground Crossings Vector Vector Surveillance and Control at PoE Project on PoE Vector Identification Platform

32 THANK YOU